OCTOBER 15 — Malaysia is pushing for strict laws on the sale and use of vapes, shisha and e-cigarettes but evidence suggests stricter vaping laws are likely to be counterproductive.
In the wake of several vaping related deaths in the United States, Health Minister Datuk Seri Dr Dzulkefly Ahmad said: “There will be more enforcement efforts to curb its accessibility.” So-called “vaping illness” has, at the last count, claimed the lives of 18 people in the US (with hundreds of others falling ill).
In efforts to curb further casualties, this summer San Francisco became the first major US city to ban all e-cigarette sales by targeting products that have yet to gain FDA approval. Massachusetts has since followed suit, with New York and Michigan banning flavoured vaping products, policy the Trump administration says it plans to enact at federal level.
India, which has the second-largest population of adult smokers in the world, is also introducing an outright ban on the sale, production, import and distribution of e-cigarettes.
As “vaping illness” panic gathers pace worldwide, on the face of it, these strict regulations on the sale and use of vapes might sound like a sensible approach. However, the situation is far more complex than that.
The real culprit in vaping illnesses
It is absolutely right that lawmakers should be monitoring the situation closely and governments should be applauded for taking this seriously. However, knee-jerk, punitive reactions could end up causing more harm than good.
While it is true that dozens of people in the US, mainly young men, have been hospitalised after vaping in recent weeks, these individuals were vaping unregulated street.
The majority of the vaping fatalities were revealed to have been using tetrahydrocannabinol (THC) oil cut with Vitamin E acetate thickening agent, not standard vape juice. The remainder of these cases may have been reluctant to admit their THC use since it’s the active ingredient in cannabis, which is illegal in the three states where these casualties were reported. Vitamin E acetate, meanwhile, has been linked to lipoid pneumonia, which can be fatal.
The obvious answer here is that black market THC cartridges are to blame. Ordinary, water-based, nicotine-containing fluids have been vaped by millions of people worldwide for over a decade. The notion that this could all of a sudden become extremely dangerous — nay, fatal — in parts of the US now is bordering on the ridiculous.
As has already been wisely noted, “just as the needle can’t be blamed for an overdose, the vaping device can’t be blamed for these illnesses.” The culprit is what the person consumed, not how they consumed it.
Why over-regulating e-cigs doesn’t work
We can observe throughout history that banning or restricting access to things is rarely effective. Look at Denmark’s fat tax, Mexico’s soda tax, or in fact e-cigarettes in Australia, a country in which there has been a similar, hardline “quit or die” smoking policy to Malaysia for close to a decade. Plain packaging for tobacco products and a ban on nicotine-containing e-cigarettes have been in place since late-2012. From this point onwards, the country’s long-term decline in smoking rates began to stall.
What we do know is that heavy-handed regulation neither helps smokers nor meets public health objectives. Rather, what has shown to be effective, is making alternatives to smoking easily accessible.
E-cigarettes have been shown time and again to be a credible and comparatively safe alternative to smoking. Their availability in the UK, and promotion by public health, likely contributed to the reduction of smoking rates from 20.4 per cent in 2012 (around the time vaping became mainstream) to 16.1 per cent in 2016.
The US has seen a similar trend. Recent research commissioned by Cancer Research UK has found that vaping can double a smoker’s chances of quitting.
Proponents of the e-cigarette ban in Malaysia say it will protect the health of children, but it’s already illegal to sell to individuals under 18 years of age. The World Health Organisation has recently suggested that e-cigarettes are a gateway for young people to start smoking.
Not only is this dangerous propaganda but the theory has been widely debunked. In June this year, research published by UK anti-smoking charity, Action on Smoking and Health (ASH), found that vaping remains uncommon among young people and is almost exclusively confined to current or past smokers. Most teen vaping is experimental and short-lived.
Young people will always be experimental. Banning vapes won’t prevent teenagers from trying them; instead, it pushes them to try something unregulated and far more toxic.
The situation is no rosier for smoking adults, the target audience of e-cigarettes, who will be forced to keep smoking (for lack of a credible alternative). This is exactly what is expected to happen in South Australia, where the State government has now banned online sales of vaping products.
It will fuel a black market in e-cigarettes in Malaysia, already suffering from the burden of rampant illegal trade in tobacco. 63 per cent of cigarettes are believed to be illicit, which equates to a huge loss in tax revenue for the Finance Ministry, money that could go towards social programmes in health and education.
While the details of e-cigarette regulation remain hotly debated, the scientific consensus on whether vaping is safer than smoking is clear. Authorities ranging from Public Health England and the Royal College of Physicians, to the National Academies of Sciences, Engineering, and Medicine agree that smokers who switch to vaping are dramatically reducing their health risks (by approximately 95 per cent).
If the Malaysian government and health authorities, including the World Health Organisation, truly want to drive down smoking rates, they should assume a leadership role in promoting vaping products as a safer alternative to cigarettes.
Policy-makers in Malaysia should draw their own conclusions after evaluating all available data, not simply react to vape hysteria.
* Jo Furnival is an Australia-based contributor who writes about health policy
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.